Non Communicable Diseases

Why in news?

A recent study published stated that the prevalence and morbidity of NCD in India has been increasing in the past decade.

What is non-communicable disease (NCD)?

• Non-communicable disease (NCD) are chronic diseases that are not caused by infectious agents and doesn’t spread from person to person.
• These diseases are long-lasting, progress slowly and often require prolonged treatment.
• Global concern – They are a major cause of death and disability worldwide, accounting for approximately 74% of all deaths globally.
• It results in 86% premature deaths (died before reaching 70 years of age) in low- and middle-income countries.
• Low middle income countries contributes 77% of all NCD cases.

What are the Risk factors for NCDS?

• A risk factor is a condition that increases the possibility of developing a non-communicable disease. The more risk factors one has, the greater the chance of getting a particular disease.
• Lifestyle choices – Poor diet, lack of physical activity and tobacco or alcohol use.
• The Lancet Global Health found that nearly 50% Indian adults insufficiently physically active.
• Genetic factors – Family history or genetic predisposition to certain diseases.
• Environmental factors – Exposure to pollution, unsafe drinking water and workplace hazards.
• Ageing – Increased risk due to natural wear and tear of body systems over time.
• Environmental factors – Air pollution is the major contributor to NCDs that accounts for 5.7 million deaths globally.

What are the types of non-communicable diseases?

• Cardiovascular diseases (CVDs) – Includes heart attacks, strokes and hypertension.
• Cancer – Is an uncontrolled cell growth in specific tissues or organs contributing 9.3 million cases annually.
• Chronic respiratory diseases – Examples include asthma and chronic obstructive pulmonary disease (COPD).
• Diabetes (type-2) – A metabolic disorder resulting in high blood sugar levels.
• Mental health disorders – Conditions such as depression and anxiety, increasingly recognized as NCDs.

What are the effects of NCDs?

• Increased health burden – Urban communities face a triple health burden during health crises due to hazardous work environments, limited healthcare access, and financial vulnerability.
• Financial instability – Catastrophic out-of-pocket on healthcare expenditures jeopardize family livelihoods and financial stability.
• Marginalized communities often lack health insurance, compounding financial stress.
• Impact on Vulnerable Populations – Informal workers, including sanitation workers, gig workers and migrants are disproportionately affected due to lack of hygiene, nutrition and contract protections.
• Social and economic marginalization of these vulnerable people exacerbates the impact on health outcomes.
• Generational health impacts – Limited access to preventive care contributes to worsening health conditions in marginalized families often persist across generations, creating a cycle of vulnerability.
• Inaccessible health care – Public health systems, designed to support the lowest 40% of the population, are often inaccessible to urban marginal.
• Growing NCD cases causes overburden on health systems that inturn fail to cater effectively.
• Widening inequality – Slum-dwelling populations and other marginalized groups face unequal access to health care highlights systemic issues in urban planning and governance.
• Economic productivity loss – Illnesses like diabetes and cardiovascular diseases reduce workforce efficiency and productivity.
• Untreated or poorly managed NCDs contribute to absenteeism and long-term incapacity among urban workers.

What are the measures to address NCD?

• Strengthen primary health care – Improve access to publicly run primary health care, especially for urban marginalized communities.
• Leverage technology – Implement real-time health monitoring using digital tools for conditions like hypertension and diabetes.
• Use screening for population-level evidence and individual awareness.
• Promote community-based solutions – Create health awareness and education among public to coordinate and work in communities with ASHA workers.
• Develop community-led NCD surveillance systems for marginalized urban settlements.

ASHAs are trained to work as an interface between the community and the public health system.

• Engage all stake holders   – Engage employers, municipalities, traffic systems, schools and health systems in dialogue to address interconnected health determinants.
• Create solutions for healthy cities through collaboration with urban local bodies and experts.
• Improve Primary Health Centers – In rural areas by increased participation and enhanced accountability for provision of better facilities to the patients in the public health facilities.
• Address Social Determinants of Health – Tackle issues related to workplace safety, housing, family connections, and community health infrastructure.
• Recognize that health outcomes are deeply tied to social identities, employment and migration status.
• Policy-level interventions – Scale up state-level action plans for better access to primary health care.
• Emphasize preventive measures to avoid catastrophic out-of-pocket (OOP) healthcare expenses.

References

1. The Hindu |India’s and its Non-Communicable Disease Burden
2. The Hindu |Prevalence Of NCDS Tripled
3. WHO |Non Communicable Diseases